Florida Medicaid recipients make fewer trips to doctors; Calif. payments to health clinics in jeopardy; Texas addresses nursing shortage

Jul 15 2010

Florida Times-Union: "Northeast Florida's Medicaid recipients are making fewer trips to the doctor for chronic illnesses since state officials outsourced the government-subsidized health insurance program to private managed care companies. But it remains unclear from the analysis performed by the Florida Agency for Health Care Administration, which oversees the state's Medicaid program, whether they're healthier for it. Medicaid reform was launched in 2006 in Duval and Broward counties to test whether HMOs could rein in the state's Medicaid spending. Baker, Clay and Nassau counties were added a year later. A University of Florida analysis last year suggested that medical costs were rising in reform counties at a slower rate compared with other parts of the state. But critics quickly lined up to attribute those savings to patients being denied care or being forced into bureaucratic tangles by the managed-care contractors" (Cox, 7/14).

The Los Angeles Times: "Health clinics that serve hundreds of thousands of California residents face the prospect of not being paid as the state lurches toward a third week of a budget stalemate — despite assertions by the state controller and Gov. Arnold Schwarzenegger's administration that providers of healthcare for the poor would be immune from missed payments. Without a spending plan in place, California cannot legally pay all its bills. But the controller said in June that all institutional health providers would be paid this year because of provisions in the federal stimulus act. Turns out, that was wrong. Officials now say that only hospitals and nursing homes will be paid in full" (Goldmacher, 7/14).

Dallas Morning News: "Tens of thousands of qualified applicants have been turned away from nursing schools for at least five years because there aren't enough teachers to conduct classes or enough clinical sites where students can get hands-on experience. Across the country, experts predict a shortage of more than 260,000 nurses by 2025. … The average age of a nurse faculty member in Texas is 54. Almost 57 percent of all nursing faculty will reach age 65 within seven years, according to the Texas Nurses Association. In Texas, one solution is to create more nurses in its own backyard rather than import them from elsewhere. The state tripled its appropriations for nursing education. The Legislature appropriated $14.7 million for the 2008-09 biennium but provided $49.7 million for the current biennium. Texas business leaders, through regional chambers of commerce, worked with the health sector to create a pay-for-performance plan" (Roberson, 7/13).

Milwaukee Magazine: "In the coming weeks, about 100,000 low-income families in Southeastern Wisconsin will receive packets of information in the mail asking them to choose from an array of new health care plans funded by the state's BadgerCare Plus insurance program. The state Department of Health Services has overhauled the program, signing new contracts with private health care providers which include new quality controls to address complaints the companies were under-performing.
The first third of the mailings, which will eventually be sent to all BadgerCare Plus members belonging to the Standard and Benchmark programs, are expected to go out next week. … Wisconsin's Badger Care uses federal Medicaid funding plus supplementary state funding to extend more medical care to families than in many other states" (Hrodey, 7/14).

Sacramento Bee: "State health insurance regulators are cracking down on insurance brokers who prey on elderly consumers confused by new federal health insurance rules. On Tuesday, the Department of Managed Health Care took steps to bar a Folsom insurance agent from selling Medicare Advantage plans after she allegedly defrauded at least 12 capital-area seniors, who then incurred thousands of dollars in unexpected medical bills." The agent [Nadia King] "is one of two dozen agents across the state getting legal scrutiny because of what officials said was deceptive marketing aimed at seniors" (Calvan, 7/14).

The Wall Street Journal: "The California Supreme Court reinstated a lawsuit in which retail pharmacies accused major drug makers of conspiring to set prices at artificially high levels. The pharmacies' lawsuit alleges Pfizer Inc. and AstraZeneca PLC as well as numerous other drug makers acted to restrain importation into the U.S. of their lower-priced foreign drugs and to restrict price competition from cheaper generic drugs. The suit claimed that as a result drug prices were 50% to 400% higher than for the same drugs sold outside the U.S. The antitrust lawsuit had previously been dismissed after a trial court and appeals court concluded that the pharmacies lacked standing because they passed on the alleged overcharges to consumers and thus sustained no damages. But in a ruling Monday, the California Supreme Court decided that drug makers couldn't use this defense and remanded the suit to lower court for further proceedings" (Loftus, 7/14).